Insulin resistance (IR) may be the root cause of most vascular disease. Treating IR can delay or completely prevent a person from ever developing diabetes.
- 70% of people with any existing plaque have IR
- IR begins an average of 15-20 years before a person is diagnosed with diabetes
- IR can cause endothelial dysfunction, inflammation, abnormal lipids, and high blood pressure. Improving IR will improve all of these
What is insulin resistance?
Insulin resistance is when insulin becomes less effective at distributing glucose from your bloodstream to organs and muscles that need it. Blood glucose levels begin to rise causing the beta cells in our pancreas to pump out extra insulin to lower the glucose. As we become more resistant, more insulin is squeezed out in an effort to keep the glucose low. Eventually, the pancreas can no longer keep up with the demand, causing our glucose to rise to the level of diabetes.
Beta cells “burn out”. It is thought that 50-75% of our beta cells burn out by the time we are diagnosed with diabetes. During the 15-20 year window before diabetes is formally diagnosed, inflammation occurs, arteries are being damaged, and cholesterol becomes dysfunctional.
Insulin is in the family of growth hormones. High insulin levels that occur with IR promote weight gain and make weight loss difficult. Wide glucose fluctuations that occur with IR cause fatigue.
I strongly believe that the weight gain and fatigue that begin to occur in many people during their 40s-60s is much more a result of IR than a “slowing metabolism”, dropping DHEA, low testosterone, or other theoretical causes of the phenomenon. Most people report increased energy after IR is improved and weight loss becomes easier.
What causes IR?
Genetics, age, visceral fat, and a lack of physical activity all contribute.
How do we diagnose IR?
A 2 hour oral glucose test (OGT) stress is needed to formally diagnose IR. During a 2 hour OGT, you will arrive and have a fasting glucose drawn. You will then drink a 75 g glucose orange drink and have glucose levels again drawn at 1 and 2 hours. Abnormal processing of the glucose defines IR.
Clues to developing insulin resistance which we will check and monitor are high visceral fat, a rising fasting glucose, the presence of metabolic syndrome, a high triglyceride/HDL cholesterol ratio, high levels of small LDL cholesterol particles, dropping HDL cholesterol, rising triglycerides, a borderline hemoglobin A1C, and a rising blood pressure.
What improves insulin resistance?
It can usually be “cured” through lifestyle changes.
- Burn visceral fat- We will discuss “fat burning” weight loss options.
- 60-90 minutes daily of any type of physical activity improves IR. This includes low intensity activities. Try to achieve 10,000 steps per day, or at least increase your baseline by 2000 steps per day. Interval exercise is very effective, but don’t start unless I clear you to do so.
- Consume low glycemic index foods. They absorb more slowly and prevent the glucose from rising as rapidly.
- Eat smaller quantities. This also prevents glucose from rising as rapidly.
- Avoid artificial sweeteners. They stimulate insulin production because our body cannot differentiate them from regular sugar.
- Certain diabetes medications like Metformin and Actos improve insulin resistance.
- Supplements that improve IR
- Cinnamon 1 g capsule daily
- Chromium Picolinate 600 mcg daily
- Magnesium – 300mg daily it can also be obtained in most calcium supplements and foods such as whole-grain cereals, brown rice, kidney and pinto beans, avocadoes, bananas, spinach, raisins, and halibut.